Stay up-to-date on topics of Internal Medicine including educational cases, guidelines, important research findings. Introduce this channel to your friends interested in Internal Medicine. Contact admin: @aasohrab
💢 Experts Recommend Medication for Pediatric MASLD Management
https://www.medscape.com/viewarticle/experts-recommend-medication-pediatric-masld-management-2025a10009vc
🆔 @internalmed
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Recent trends in use of tirzepatide, a dual glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide receptor agonist (RA), versus other glucose-lowering medications (GLMs) and weight-lowering medications (WLMs).
🆔 @internalmed
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💢 Iron Deficiency Anemia - JAMA 2025
🆔 @internalmed
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💢 U.S. Emergency Department Visits Attributed by Clinicians to Semaglutide Adverse Events, 2022–2023
National data from 2022 to 2023 estimated that for every 1,000 patients prescribed semaglutide (Ozempic, Wegovy), there were fewer than four adverse event-related emergency department visits, mainly for gastrointestinal symptoms.
🆔 @internalmed
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💢 Improvements in Obesity and Associated Comorbid Conditions With GLP-1 and GLP-1/GIP Receptor Agonists
🆔 @internalmed
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💢 Fatty Liver Disease Nearly Doubles Mortality Risk
https://www.medscape.com/viewarticle/fatty-liver-disease-nearly-doubles-mortality-risk-2025a10007l7?src=rss
🆔 @GIJournalClub
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💢 Parental alcohol use may increase cancer risk among children
https://www.healio.com/news/hematology-oncology/20250327/parental-alcohol-use-may-increase-cancer-risk-among-children
🆔 @internalmed
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💢 Diagnosis and management of chronic
rhinosinusitis
🆔 @internalmed
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💢 SGLT‑2 inhibitors and diabetic ketoacidosis
🆔 @internalmed
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💢 Five things to know about Vitiligo
🆔 @internalmed
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فانا: نسل جدید داروهای کاهش وزن در راهند
🔹داروی Orforglipron، ایلای لیلی، ۲۰۲۶
🔹داروی CagriSema، نوو نوردیسک، ۲۰۲۶
🔹داروی Survodutide، بوهرینگر اینگلهایم، ۲۰۲۷
🔹داروی Retatrutide، ایلای لیلی، ۲۰۲۷
🔹داروی MariTide، امژن، ۲۰۲۸ و بعد از آن
🔹داروی Bimagrumab، ایلای لیلی، ۲۰۲۸ و بعد از آن
🔹داروی Monlunabant، نوو نوردیسک، ۲۰۲۸ و بعد از آن/نیچر
www.daroovasalamat.ir/news/58104
@phanair
نوروز زیبا مبارک 🎉
امید که سال جدید سال شادمانی
و خبرهای خوش باشد. ✨💐
امیرعلی سهرابپور
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💢 Alcohol and Blood Pressure Fact Sheet
➖ High quality clinical and experimental studies show that alcohol intake increases blood pressure, especially in the hours and days after consumption and for higher levels of alcohol use.
➖High quality studies with randomization find no evidence that low level alcohol use has beneficial effects on blood pressure or hypertension
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https://alcoholandsociety.report/
🆔 @internalmed
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💢 Does Continuing Metformin in Hospitalized Patients with Type 2 Diabetes Affect Posthospitalization Outcomes?
An observational study suggests inpatient continuation is associated with lower risk for hypoglycemia and death after discharge.
Current guidelines recommend holding metformin in hospitalized patients, given hospitalized patients' potential excess risk for lactic acidosis due to hemodynamic instability, hypoxia, congestive heart failure (CHF), or acute kidney injury.
However, critics contend that many patients without contraindications should continue to receive metformin in the hospital since no evidence shows that it is harmful, and it might have benefits such as avoiding hypoglycemia, which is more common with insulin.
Researchers conducted a propensity-matched observational study in 67,000 adult patients (97% men) with type 2 diabetes who were admitted to Veterans Health Affairs (VHA) hospitals. Half of patients continued and half discontinued metformin during hospitalization.
Patients with glomerular filtration rate (GFR) ≤30 mL/minute/1.73 m2 and those who died during the index hospitalization were excluded.
Importantly, patients with sepsis, CHF, gastrointestinal bleeding, pancreatitis, and other comorbidities were included.
Within 90 days of discharge, those who received metformin were significantly less likely to develop hypoglycemia (the primary outcome; 1.5% vs. 1.8%), perhaps because recipients of metformin during hospitalization were less likely to be discharged on insulin.
The metformin group also had significantly lower 90-day mortality and lower readmission rates (absolute difference, ≈1% lower for each outcome).
COMMENT
This study is notable because of the researchers' inclusion of patients with comorbidities that are associated with risk for lactic acidosis and (presumably) worse outcomes.
Backed by these findings, clinicians can reasonably assume that continuing metformin in hemodynamically stable hospitalized patients with GFR >30 mL/minute/1.73 m2 is safe and might improve outcomes after hospital discharge. Although most patients in this study were men, there is no obvious reason that the findings wouldn't apply to women.
🆔 @internalmed
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💢 CT Scans Linked to New Cancer Diagnoses in U.S., But Overall Risk is Low
A recent study highlighted in JAMA Internal Medicine suggests that computed tomography (CT) scans may slightly increase a person's lifetime risk of developing cancer due to exposure to ionizing radiation.
The cumulative effect of repeated scans over time is of particular concern, especially as the number of CT scans performed in the United States has risen by over 30% since 2007.
The study estimates that CT scans performed in 2023 could be linked to approximately 103,000 future cancer cases, potentially accounting for about 5% of all new cancer diagnoses in the United States.
The risk is higher in children and adolescents compared to adults, with the most common projected cancers in adults being lung, colon, leukemia, and bladder cancer. In women, breast cancer was the second most common, while in children, thyroid, lung, and breast cancers were most frequently projected.
The highest number of cancers in adults was projected to result from CT scans of the abdomen and pelvis, followed by chest scans. In children, head CT scans were most associated with future cancer risk.
Despite these projections, experts emphasize that the absolute risk remains minimal and must be considered over decades of follow-up.
Balancing Benefits and Risks
CT scans are crucial diagnostic tools, often saving lives by enabling early detection and treatment of serious conditions such as cancer, blood clots, and internal bleeding.
The American College of Radiology (ACR) and other experts stress that, while the theoretical cancer risk exists, the benefits of medically necessary CT scans far outweigh the risks, especially when used appropriately.
CT imaging has been directly linked to declining cancer death rates, reduced need for invasive surgeries, and improved life expectancy.
Experts recommend that patients and healthcare providers engage in shared decision-making, weighing the necessity and frequency of CT scans against potential risks.
Reducing the number of unnecessary scans and lowering the dose per scan are practical steps to decrease potential future cancer cases.
🆔 @internalmed
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💢 Cannabis and Cannabinoids for Chronic Non-cancer Pain: Guidance from the ACP
Cannabis-based products can be prescribed legally for medicinal uses in some U.S. states, and many patients (regardless of their local laws) use these products to manage chronic pain.
The ACP now has published best-practice advice on risks and benefits of cannabis and cannabinoids for chronic non-cancer pain; the authors' analysis was based primarily on 26 randomized trials and 12 observational studies, most of which focused on neuropathic pain.
Products with high ratios of Δ-9-tetrahydrocannabinol (THC) to cannabidiol (CBD) — i.e., ≥2:1 — were associated with small improvements in pain and medium-to-high risks for dizziness, nausea, and sedation compared with placebo or usual care.
Products with low THC–CBD ratios (<1:2) did not improve pain and were associated with medium-to-high risks for dizziness, nausea, and sedation.
Potential long-term harms included cannabis use disorder, cognition changes, cannabis hyperemesis syndrome, and psychosis.
Clinicians should counsel patients about potential benefits and harms of using cannabis and cannabinoids for chronic non-cancer pain. The authors give three additional recommendations:
- Harms likely outweigh benefits for young adults (age, ≤25), patients with substance use disorder (past or current) or serious mental illness, and those with high risk for falls.
- Patients who are pregnant, breastfeeding, or actively trying to conceive should not use these products.
- All patients should avoid inhaled cannabis.
COMMENT
The information in this advisory will help guide conversations with patients. It is most applicable to clinicians and patients in states with “medical” cannabis-based products and robust quality-control measures. Outside of these regulatory frameworks, the content of cannabis-based products can differ substantially from product labeling, given limited oversight of production
🆔 @internalmed
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💢 The Evolving Role of Weight Loss
Pharmacotherapy
🆔 @internalmed
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💢 Semaglutide Use Linked to Risk for Vision Loss in Diabetes
https://www.medscape.com/viewarticle/semaglutide-use-linked-risk-vision-loss-diabetes-2025a10007g9?src=rss
🆔 @internalmed
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💢 An educational case of MASLD and its complications
🆔 @GIJournalClub
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💢 Current Medical Diagnosis & Treatment 2025, Sixty-Fourth Edition
🆔 @internalmed
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💢 🎧 First time visit for a 73-Year-Old man
https://podcasts.apple.com/us/podcast/harrisons-podclass-internal-medicine-cases-and-board-prep/id1453765092?i=1000701108765
🆔 @internalmed
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💢 🎧 Diagnosis, Treatment, and Prognosis of ADPKD
https://podcasts.apple.com/us/podcast/jama-clinical-reviews/id1027430378?i=1000700613183
🆔 @internalmed
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💢 Lupus vulgaris (skin TB) in a 58-year-old man
🆔 @internalmed
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💢 Sarcoidosis with diffuse purplish erythematous plaques on the hands
https://www.ccjm.org/content/ccjom/92/3/145.full.pdf
🆔 @internalmed
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💢 🎧 Chronic Myeloid Leukemia: A Review
https://edhub.ama-assn.org/jn-learning/audio-player/10.1001/jama.2025.2283
🆔 @internalmed
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💢 HPV vaccination: How the world can eliminate cervical cancer
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https://ourworldindata.org/hpv-vaccination-world-can-eliminate-cervical-cancer
🆔 @internalmed
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💢 Recent advances in the management of knee osteoarthritis: a narrative review
🆔 @Internalmed
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